Malnutrition decreases quality of life, social function in cirrhosis

PHILADELPHIA — Malnutrition as measured by subjective global assessment correlated significantly with decreased health-related quality of life in patients with cirrhosis, according to research presented at the American College of Gastroenterology Annual Meeting.

“I was quite surprised by how limited the literature was in regards to malnutrition and quality of life in cirrhosis, given that the prevalence of malnutrition in cirrhosis is so high and the complications of malnutrition are quite profound, including infections, portal hypertension and increased hospitalizations and mortality,” Elaine Chiu, MD, RD, from the University of Calgary in Alberta, Canada, said during her presentation.

Chiu and colleagues used nutrition assessment tools such as the subjective global assessment (SGA), mid-arm circumference and hand-grip strength and compared results with MELD-Na score to explore the influence of nourishment state in patients with cirrhosis.

The study comprised 81 patients with cirrhosis who had not undergone liver transplantation. The patients completed the 36-item Short Form (SF-36) questionnaire to determine health-related quality of life (HRQoL).

Results from the SGA assessment showed that 30% of patients were well-nourished, 43% were moderately malnourished and 27% were severely malnourished.

Malnutrition correlated significantly with lower HRQoL (P < .05). On a scale of 100, severely malnourished patients scored lower on the SGA than those who were well-nourished in the categories of vitality (30 vs. 48), role physical (17 vs. 47), physical function (38 vs. 63) and social function (45 vs. 70).

While hand-grip strength showed a significant association with the physical function subscale of the SF-36, mid-arm circumference and MELD-Na did not correlate with any subscale.

“Bringing this altogether in regard to clinical relevance for our patients, I want to emphasize again that malnutrition was prevalent in 70% of our patients and I suspect this would reflect in similar patients around the world,” Chiu said. “Preventing malnutrition could certainly improve quality of life in our patients with cirrhosis and simple tools like the SGA are readily available and can be utilized in the clinic setting.” – by Talitha Bennett

Reference : Chiu E. Abstract 16. Presented at: American College of Gastroenterology Annual Scientific Meeting; Oct. 5-10, 2018; Philadelphia.

Disclosure: Chiu reports no relevant financial disclosures.